CMS Data

Showing 1 to 20 of 46 results.
  1. Carrier RIF

    The Carrier file (also known as the Physician/Supplier Part B claims file) contains final action fee-for-service claims submitted on a CMS-1500 claim form. Most of the claims are from non-institutional providers, such as physicians, physician assistants, ...

  2. Durable Medical Equipment RIF

    The Durable Medical Equipment (DME) file contains final action, fee-for-service claims submitted by Durable Medical Equipment suppliers. This file includes: diagnosis, (ICD-9 diagnosis), services provided (CMS Common Procedure Coding System (HCPCS) codes) ...

  3. Home Health Agency RIF

    The Home Health Agency (HHA) file contains final action, fee-for-service claims submitted by HHA providers. This file includes: the number of visits, type of visit (skilled-nursing care, home health aides, physical therapy, speech therapy, occupational ...

  4. Hospice RIF

    The Hospice file contains final action claims submitted by Hospice providers. Once a beneficiary elects Hospice, all Hospice related claims will be found in this file, regardless if the beneficiary is in Medicare fee-for-service or in a Medicare managed ...

  5. Vital Status File with Name and Address

    The Vital Status File with Name and Address contains demographic information about each beneficiary ever entitled to Medicare. This file includes: the beneficiary unique identifier mailing contact address date of birth date of death sex, race, and age ...

  6. UPIN Member File

    The UPIN Member File provides information about physicians who are members of a group practice. The file provides information about the group practice and the individual physicians that are members of the group. Short Name:  UPIN Member Category:  ...

  7. MPIER File

    The Medicare Physician Identification and Eligibility Records (MPIER) file contains one record for each practice setting for a physician. Thus, a physician will have multiple records in this file depending on the number of practice locations, specialties ...

  8. Part D Drug Characteristics File

    The drug characteristics file is a supplemental set of variables that are appended to the Part D Event data.   The drug characteristics file contains four variables from the First DataBank® (FDB) reference file. The variables include: brand name, generic ...

  9. Part D Prescriber Characteristics File

    The Prescriber Characteristics file contains information about the practitioner who prescribed the drug.  Prescriber identifiers are encrypted in the Part D data, so researchers must link this file with the Prescriber id in order to obtain more ...

  10. Health Outcomes Survey RIF

    HOS is an outcomes measurement tool used for Medicare Advantage plans. The goal of the Medicare HOS program is to gather valid and reliable health status data in Medicare managed care plans for use in quality improvement activities, plan accountability, ...

  11. Long Term Care Minimum Data Set 2.0

    The Long Term Care Minimum Data Set (MDS) is a standardized, primary screening and assessment tool of health status which forms the foundation of the comprehensive assessment for all residents (regardless of payer) of long-term care facilities certified ...

  12. Swing-Bed Assessments 2.0

    Swing-Bed providers are hospitals that can use its beds, as needed, to provide either acute or SNF care. A provider must complete an assessments for patients that are in a swing bed in order to receive payment.  The Swing-Bed MDS is a subset of the MDS ...

  13. Beneficiary Summary File

    The Beneficiary Summary File includes the beneficiary unique identifier, state and county codes, zipcode, date of birth, date of death, sex, race, age, monthly entitlement indicators (A/B/C/D), reasons for entitlement, and monthly managed care indicators ...

  14. Health and Retirement Survey- Medicare Linked Data

    One of the main goals of the Health and Retirement Study (HRS) is to understand the relationship between medical history and financial status, and how use of health care may change as people age. To assist in this effort, the HRS endeavors to obtain ...

  15. Renal Management Information System

    REMIS determines Medicare coverage periods for ESRD patients and serves as the primary mechanism to store and access information in the congressionally-mandated ESRD Program Management and Medical Information System Database. REMIS tracks the ESRD patient ...

  16. Inpatient RIF

    The Inpatient file contains final action fee-for-service claims data submitted by inpatient hospital providers for reimbursement of facility costs. This file includes: diagnosis (ICD-9 diagnosis), procedure (ICD-9 procedure code), Medicare Severity ...

  17. Outpatient RIF

    The Outpatient file contains final action, fee-for-service claims data submitted by institutional outpatient providers. Examples of institutional outpatient providers include hospital outpatient departments, rural health clinics, renal dialysis facilities ...

  18. Skilled Nursing Facility RIF

    The Skilled Nursing Facility (SNF) file contains final action, fee-for-service, claims data submitted by SNF providers. This file includes: diagnosis (ICD-9 diagnosis), and procedure (ICD-9 procedure code), dates of service, reimbursement amount, SNF ...

  19. Part D Drug Event File

    The PDE data contain prescription drug costs and payment data that enable CMS to make payments to the plans and otherwise administer the Part D benefit.  When a beneficiary fills a prescription under Medicare Part D, a prescription drug plan sponsor must ...

  20. Part D Pharmacy Characteristics File

    The pharmacy charactersitics file provides information about the type of pharmacy  (e.g., community/retail pharmacy, mail order, institutional pharmacy), the location of the pharmacy (i.e., state), and whether the pharmacy has a relationship with a common ...

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